Issue 10, 2024

Advances in uremic toxin detection and monitoring in the management of chronic kidney disease progression to end-stage renal disease

Abstract

Patients with end-stage kidney disease (ESKD) rely on dialysis to remove toxins and stay alive. However, hemodialysis alone is insufficient to completely remove all/major uremic toxins, resulting in the accumulation of specific toxins over time. The complexity of uremic toxins and their varying clearance rates across different dialysis modalities poses significant challenges, and innovative approaches such as microfluidics, biomarker discovery, and point-of-care testing are being investigated. This review explores recent advances in the qualitative and quantitative analysis of uremic toxins and highlights the use of innovative methods, particularly label-mediated and label-free surface-enhanced Raman spectroscopy, primarily for qualitative detection. The ability to analyze uremic toxins can optimize hemodialysis settings for more efficient toxin removal. Integration of multiple omics disciplines will also help identify biomarkers and understand the pathogenesis of ESKD, provide deeper understanding of uremic toxin profiling, and offer insights for improving hemodialysis programs. This review also highlights the importance of early detection and improved understanding of chronic kidney disease to improve patient outcomes.

Graphical abstract: Advances in uremic toxin detection and monitoring in the management of chronic kidney disease progression to end-stage renal disease

Supplementary files

Article information

Article type
Critical Review
Submitted
12 Sun 2024
Accepted
16 Dzi 2024
First published
16 Dzi 2024

Analyst, 2024,149, 2784-2795

Advances in uremic toxin detection and monitoring in the management of chronic kidney disease progression to end-stage renal disease

H. Lee, K. Liu, Y. Yang, J. Liao, B. Lin, Z. Wu, A. C. Chang, C. Tseng, M. Wang and Y. Tsai, Analyst, 2024, 149, 2784 DOI: 10.1039/D4AN00057A

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